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APA PA SE Carpool Form
We are interested in helping coordinate carpooling from the Philadelphia region to the APA PA State Conference in Erie in October 2024.
Please fill out the form below whether you are looking to drive or be a passenger, and we will put you in touch with someone who may be a good fit!
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* Indicates required question
Are you interested in carpooling as:
*
Choose
Drive own vehicle
Passenger
Either
Your APA Chapter:
*
Choose
Southeast
Lehigh Valley-Berks
If you plan to be a driver, how many passengers (excluding yourself) can you comfortably and safely accommodate?
Choose
1
2
3
4
5
6
7
8
Not Applicable
Origin/Pickup Location
*
Please describe where you will need to be picked up/dropped-off, preferably with an address.
Your answer
When do you plan to depart?
*
Choose
On Saturday (October 12th)
On Sunday (October 13th)
Other
If you are departing at another time, please describe
Your answer
When do you plan to return home?
*
Choose
After sessions end on Monday (October 14th)
After lunch on Tuesday (October 15t)
After the conference ends on Tuesday
Other
If you are returning home at a different time, please describe:
Your answer
If you have any special circumstances that need to considered, please list them.
Your answer
If a carpooling arrangement cannot be made to suit your schedule, will you still plan to attend the conference?
*
Choose
Yes
No
Follow-up Contact Information
Your contact information will be used by the carpool organizers and may be used to put you in contact with others who you may carpool with.
Name
*
Your answer
Email Address
*
Your answer
Phone number
Your answer
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